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3 The Elderly without Coverage Medicare as universal insurance for the elderly 350,000 people in the U.S. elderly & uninsured in 2000 (Mold, Fryer, & Thomas, 2004) Mix of individuals not eligible for Medicare Immigrants, Unusual work history May also be Medicaid ineligible Likely rely on hospital charity care Little data to describe extent & trends in use Hospital CC database in NJ

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4 Study objectives 1.Describe prevalence & growth in hospital CC use by the elderly. 2.Compare CC use by the elderly (65+) to corresponding use by children (0-18) & non- elderly adults (19-64). 3.Compare CC costs & services used by the elderly to other age groups.

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20 Implications for SN hospitals Use of CC by the elderly more common & more expensive ==> higher costs per case ==> greater financial burden on SN hospitals ==> Shift to different service mix ==> increased demand for unreimbursed services addressing needs of the elderly Similar trends in other states? SCHIP, Aging population, Immigration